PROJECT SUMMARY (See instructions); This project collaboratively forges an alternative future for American Indian people relative to diabetes. Several disciplines are joined from within the clinical health, social, behavioral, and cultural sciences as well as native advisors to comprise the intellectual engine of this proposed center. Knitting these diverse professional cultures into an effective interdisciplinary force will be done by iterative psychoeducational seminars. The Specific Aims are to reduce health disparities among American Indian (Al) people by 1) conducting medical and sociocultural research strengthening diabetes prevention and management in the context of contemporary Al culture, 2) developing interdisciplinary values and skills pervading all operations, 3) developing curricula fostering new skills and manpower in health disparities research, 4) collaborating with Al communities to produce diabetes education in culturally appropriate ways using new, easily accessed media, and 5) administering Center operations by Al's with Al perspectives that honor all people and things. The Administrative Core is composed of the PI, Project Coordinator, Administrative Director, and two staff assistants. This Core will manage all Center functions. The Research Core has three Research Sub- Projects: 1) discovering cultural categories of parental distress due to diabetes care of children with Type 1and 2 diabetes for use in behavioral medicine counseling, 2) testing efficacy of financial incentives for increasing physical activity in obese youth and change in cardiometabolic status, and 3) comparing the differential risk for preeclampsia among Caucasian, American Indian, and Hispanic women to explore hypothesized protective effects in indigenous people of the Western hemisphere. The Research Training/Education Core will 1) develop a new certificate program in nursing on health disparity reduction research, practice, and ethics, 2) develop the capacity to produce a series of 12-minute video stories (a highly valued approach to teaching among Al's) for dissemination and evaluation, and 3) conduct education on diabetes to Al adults with integrated encouragement to serve as health disparities research subjects. The Community Engagement/Outreach Core will 1) conduct a Youth Asset building program using community, family, and individual factors that assist youth in avoiding risky health behaviors, 2) evaluate the CDC Eagle Books in public schools with high Al enrollment, and 3) add a new community partner comprised of owners of rural, small food stores to begin promoting healthy foods, and 4) continue the Oklahoma City Area Intertribal Health Board partnership of all tribes in Oklahoma. Texas, and Kansas.

RELEVANCE (See instructions): This project will improve the public's health by reducing the unacceptably huge diabetes health disparity crisis among Al people through finding better means to: provide clinical care in its treatment, prevent onset, reduce familial distress in chronic disease coping, develop better healthy decision-making among youth, and develop better means to communicate healthy lifestyle choices. The project also creates a collaboration with rural, small food outlets as "Good Food Neighbors" to promote selling healthier foods and introduces "digital storytelling" appropriate to Indian Country by the production of a series of real stories of success in diabetes coping and prevention.